05537nas|a2200409 i 4500 20260817163130.0 030912s2003 th uzm rtt 00| a1eng d .b11898823 AIT Diss. no.EV-03-01 Akter, Nasima Appropriate management options for medical waste in developing countries : the case of Bangladesh and Thailand Bangkok : Asian Institute of Technology, 2003 210 p. Dissertation ; no. EV-03-01 A dissertation submitted in paitial fulfillment of the requirements for the degree of Doctor of Technical Science. The primary goal of this research was to formulate appropriate environmental management options of the medical waste for developing countries. The purpose was to improve the health condition of the people and environmental quality of developing country with special emphasis to Bangladesh. Therefore, the overall objective of this study was to assess the effects of disposed medical wastes on health and environment and develop a management intervention to improve the medical waste disposal system in developing countries, specially Bangladesh and Thailand. Specific objectives of the study were to (1) review the current status of hospital waste management (policy, regulation and practices) in Thailand and Bangladesh and draw references from other developed countries; (2) compare the management techniques and practices in Thailand and Bangladesh related to proper handling and disposal of medical waste; (3) determine the effectiveness of infectious waste handling and disposal by testing pathogens; and ( 4) recommend appropriate management options for medical waste, in developing country specifically in Thailand and Bangladesh. Study conducted mainly 2 cities in Bangladesh and 2 cities in Thailand. Study concentrate on hospitals waste generation, management and waste disposal sites. Health and environmental aspects of waste in and out of hospital premises and disposal site were taken into account. Data and info1mation were collected (March 2000 to March 2001) through (i) literature review (ii) secondary data (iii) interview (iv) field investigation (v) questionnaire survey (vi) laboratory analysis (vii) discussion (viii) observation and (ix) case studies. Overall situation analysis showed the evidence of a lack of proper attention given by hospital authority. There were lack of resource availability; training, monitoring, and evaluation; adequate law and negligence in implementation, enforcement of existing law in proper medical waste management in Bangladesh and Thailand. It was also observed that Thailand has better situation compare to Bangladesh in relation to infectious waste management, training, guidelines and regulations. Few identified problems related to waste management was lack of cooperation between different agencies; lacks of proper waste management policy, specified standard, and regular monitoring. Resource availability, skilled manpower, awareness should also be taken into account to address the proper medical waste management issue. Overall finding also indicates that there was a lacking in in-house management of medical waste both the countries with some extents. There were good initiatives found in the case studies of two countries. Such as, building awareness among local community to the higher authority, using bottom-up approach of management; involvement of local community and all stockholders in planning and implementation of project; in-house training and evaluation; good housekeeping as well as low cost technology of collection, storage. Treatment and disposal; and sharing the facilities with small hospitals. Improvements in medical waste management involve a number of activities, which can be undertaken as a series of small steps on the road to improvement. Considering the whole situation there are some specific suggestions and recommendations for medical waste and infectious waste management. These were adequate in-house treatment/ management; cost reduction of management; formulation and enforcement of laws and regulations. Suggestions were made for each aspect that influences or related to medical waste management. An action plan with appropriate options has been given for Bangladesh and Thailand at the end of this dissertation. Thesis (Ph.D.) - Asian Institute of Technology, 2003 Medical wastes Bangladesh Medical wastes Thailand Trankler, Josef, Chairperson Preeda Pakpian, Examination Committee Zakir Hussain, Examination committee Skorn Mongkolsuk, Examination Committee Aga Khan Foundation,Geneva, Switzerland, Scholarship donor Asian Institute of Technology. Dissertation ; no. 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